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[PMID]:28954297
[Au] Autor:Bandos H; Melnikow J; Rivera DR; Swain SM; Sturtz K; Fehrenbacher L; Wade JL; Brufsky AM; Julian TB; Margolese RG; McCarron EC; Ganz PA
[Ad] Endereço:NRG Oncology and The University of Pittsburgh, Pittsburgh, PA; Center for Healthcare Policy and Research, University of California Davis, Sacramento, CA; Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD; NRG Oncology and The Washington Cancer Institute at
[Ti] Título:Long-term Peripheral Neuropathy in Breast Cancer Patients Treated With Adjuvant Chemotherapy: NRG Oncology/NSABP B-30.
[So] Source:J Natl Cancer Inst;110(2), 2018 Feb 01.
[Is] ISSN:1460-2105
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: The long-term effects of chemotherapy are sparsely reported. Peripheral neuropathy (PN) is one of the most frequent toxicities associated with taxane use for the treatment of early-stage breast cancer. We investigated the impact of the three different docetaxel-based regimens and patient characteristics on long-term, patient-reported outcomes of PN and the impact of PN on long-term quality of life (QOL). Methods: The National Surgical Adjuvant Breast and Bowel Project Protocol B-30 was a randomized trial comparing sequential doxorubicin (A) and cyclophosphamide (C) followed by docetaxel (T) (AC→T), concurrent ACT, or AT in women with node-positive, early-stage breast cancer. The AC→T group had a higher cumulative dose of T. PN was one of the symptoms assessed in a QOL substudy. Statistical methods included simple and mixed ordinal logistic regression and general linear models. All statistical tests were two-sided. Results: Of 1512 patients, 41.9% reported PN two years after treatment initiation. Treatment with AT and ACT was associated with less severe long-term PN compared with AC→T (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.35 to 0.58; OR = 0.59, 95% CI = 0.46 to 0.75). Preexisting PN, older age, obesity, mastectomy, and greater number of positive nodes were also associated with higher risk of long-term PN. Patients who reported worse PN symptoms at 24 months had statistically significantly worse QOL (Ptrend < .001). Conclusions: The administration of docetaxel is associated with long-term PN. The lower rate of long-term PN in AT and ACT patients might be an important consideration in supporting choosing these therapies for individuals with preexisting neuropathic symptoms or other risk factors for neuropathy.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias da Mama/tratamento farmacológico
Doenças do Sistema Nervoso Periférico/induzido quimicamente
[Mh] Termos MeSH secundário: Quimioterapia Adjuvante
Ciclofosfamida/efeitos adversos
Doxorrubicina/administração & dosagem
Doxorrubicina/efeitos adversos
Esquema de Medicação
Feminino
Seres Humanos
Meia-Idade
Qualidade de Vida
Taxoides/administração & dosagem
Taxoides/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Taxoids); 15H5577CQD (docetaxel); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1093/jnci/djx162


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[PMID]:28954296
[Au] Autor:Rivera DR; Ganz PA; Weyrich MS; Bandos H; Melnikow J
[Ad] Endereço:Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD; Schools of Medicine and Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA; Center for Healthcare Policy and Research, University of California Davi
[Ti] Título:Chemotherapy-Associated Peripheral Neuropathy in Patients With Early-Stage Breast Cancer: A Systematic Review.
[So] Source:J Natl Cancer Inst;110(2), 2018 Feb 01.
[Is] ISSN:1460-2105
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Breast cancer is the most common cancer among women worldwide, and survival rates are increasing. Chemotherapy-associated peripheral neuropathy (PN) is clinically important because of effects on quality of life (QOL) and potential effects on dose limitations. This adverse drug reaction is associated with certain classes of chemotherapy and commonly presents as peripheral sensory neuropathy whose natural course is largely unknown. The literature was reviewed to determine the frequency and characteristics of PN associated with adjuvant chemotherapy in early-stage breast cancer (ESBC) to explore the potential impact on long-term (one or more years after diagnosis) health outcomes and QOL. MEDLINE, PubMed, Embase, and the Cochrane Library were searched for relevant English-language randomized controlled trials, systematic reviews, meta-analyses, and case-control and cohort studies published between January 1990 and July 1996. Included studies were limited to current adjuvant regimens (eg, anthracyclines, taxanes, cyclophosphamide, platinum compounds). Two investigators independently reviewed abstracts, full-text articles, and extracted data from fair- and good-quality studies. Discrepancies in quality assessment and data extraction were resolved by consensus. We identified 364 articles; 60 were eligible for full-text review. Only five reports of four studies provided data beyond one year post-treatment initiation. Studies used different measures to assess PN. Neuropathic symptoms persisted in 11.0% to more than 80% of participants at one to three years following treatment. There is a paucity of data describing persistent PN in ESBC patients. Consistent use of validated measures and well-conducted randomized clinical trials or observational studies are needed to evaluate the incidence, persistence, and QOL associated with the long-term effects of PN.
[Mh] Termos MeSH primário: Antineoplásicos/efeitos adversos
Neoplasias da Mama/tratamento farmacológico
Neoplasias da Mama/patologia
Doenças do Sistema Nervoso Periférico/induzido quimicamente
[Mh] Termos MeSH secundário: Antineoplásicos/uso terapêutico
Feminino
Seres Humanos
Estadiamento de Neoplasias
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1093/jnci/djx140


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[PMID]:29390506
[Au] Autor:Anzai M; Morikawa M; Okuno T; Umeda Y; Demura Y; Sonoda T; Yamaguchi M; Kanno K; Shiozaki K; Ameshima S; Akai M; Ishizuka T
[Ad] Endereço:Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui.
[Ti] Título:Efficacy and safety of nanoparticle albumin-bound paclitaxel monotherapy as second-line therapy of cytotoxic anticancer drugs in patients with advanced non-small cell lung cancer.
[So] Source:Medicine (Baltimore);96(51):e9320, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nanoparticle albumin-bound paclitaxel (nab-PTX), which avoids toxicities associated with a vehicle used in solvent-based PTX, has already shown safety and efficacy in patients with non-small cell lung cancer (NSCLC). METHODS: A phase II study was performed to assess the safety and efficacy of nab-PTX monotherapy as second-line chemotherapy after cytotoxic anticancer drugs for previously treated advanced NSCLC. Thirty-two patients with advanced NSCLC who had previously undergone 1 regimen of cytotoxic anticancer drugs were enrolled. Nab-PTX was administered intravenously at a dose of 100 mg/m on days 1, 8, and 15 of a 28-day cycle. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and toxicity profile were evaluated. RESULTS: The ORR was 28.1%, the DCR was 71.9%, median PFS was 3.9 months (95% confidence interval [CI] 2.7-5.1 months), and median OS was 10.9 months (95% CI 9.5-12.3 months). The mean relative dose intensity of nab-PTX was 77%. Grade 3 or 4 neutropenia, and grade 3 febrile neutropenia were observed in 11 and 1 of 32 patients, respectively. As nonhematologic toxicities, grade 3 peripheral sensory neuropathy and pneumonitis were each observed in 2 of 32 patients. CONCLUSION: Nab-PTX is an active and well-tolerated regimen in patients with previously treated NSCLC.
[Mh] Termos MeSH primário: Paclitaxel Ligado a Albumina/uso terapêutico
Antineoplásicos/uso terapêutico
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico
Neoplasias Pulmonares/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Anemia/induzido quimicamente
Carcinoma Pulmonar de Células não Pequenas/mortalidade
Feminino
Seres Humanos
Japão/epidemiologia
Neoplasias Pulmonares/mortalidade
Masculino
Meia-Idade
Neutropenia/induzido quimicamente
Doenças do Sistema Nervoso Periférico/induzido quimicamente
Pneumonia/induzido quimicamente
Terapia de Salvação
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Albumin-Bound Paclitaxel); 0 (Antineoplastic Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009320


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[PMID]:29237697
[Au] Autor:Roucher-Boulez F; Brac de la Perriere A; Jacquez A; Chau D; Guignat L; Vial C; Morel Y; Nicolino M; Raverot G; Pugeat M
[Ad] Endereço:Laboratoire de Biochimie et Biologie Moléculaire Grand EstUM Pathologies Endocriniennes Rénales Musculaires et Mucoviscidose, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France florence.roucher@chu-lyon.fr.
[Ti] Título:Triple-A syndrome: a wide spectrum of adrenal dysfunction.
[So] Source:Eur J Endocrinol;178(3):199-207, 2018 Mar.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Triple-A or Allgrove syndrome is an autosomal recessive disorder due to mutations in the gene, which encodes a nucleoporin named ALADIN. It is characterized by a classical clinical triad: alacrima, achalasia and adrenal insufficiency, the canonic symptoms that are associated with progressive peripheral neuropathy. Only a few cohorts have been reported. The objective of the present study was to characterize the various spectra of adrenal function in Triple-A patients. METHODS: A retrospective clinical and biological monitoring of 14 patients (10 families) was done in a single multidisciplinary French center. All had gene sequenced and adrenal function evaluation. RESULTS: Nine different mutations were found, including one new mutation: c.755G>C, p.(Trp252Ser). Regarding adrenal function, defects of the zona fasciculata and reticularis were demonstrated by increased basal ACTH levels and low DHEAS levels in all cases regardless of the degree of glucocorticoid deficiency. In contrast, mineralocorticoid function was always conserved: i.e., normal plasma renin level associated with normal aldosterone level. The main prognostic feature was exacerbation of neuropathy and cognitive disorders. CONCLUSIONS: These data suggest that, in Triple-A patients, adrenal function can be deficient, insufficient or compensated. In our cohort after the first decade of life, there does not appear to be any degradation of adrenal function over time. However, patients with compensated adrenal function should be informed and educated to manage a glucocorticoid replacement therapy in case of stressful conditions, with no need for systematic long-term treatment.
[Mh] Termos MeSH primário: Insuficiência Adrenal/genética
Acalasia Esofágica/genética
Proteínas do Tecido Nervoso/genética
Complexo de Proteínas Formadoras de Poros Nucleares/genética
[Mh] Termos MeSH secundário: Adolescente
Insuficiência Adrenal/complicações
Insuficiência Adrenal/metabolismo
Insuficiência Adrenal/fisiopatologia
Hormônio Adrenocorticotrópico/metabolismo
Adulto
Idoso
Aldosterona/metabolismo
Criança
Transtornos Cognitivos/etiologia
Transtornos Cognitivos/fisiopatologia
Transtornos Cognitivos/psicologia
Estudos de Coortes
Sulfato de Desidroepiandrosterona/metabolismo
Progressão da Doença
Acalasia Esofágica/complicações
Acalasia Esofágica/metabolismo
Acalasia Esofágica/fisiopatologia
Feminino
França
Glucocorticoides/deficiência
Seres Humanos
Masculino
Meia-Idade
Doenças do Sistema Nervoso Periférico/etiologia
Doenças do Sistema Nervoso Periférico/fisiopatologia
Fenótipo
Prognóstico
Renina/metabolismo
Estudos Retrospectivos
Adulto Jovem
Zona Fasciculada/metabolismo
Zona Reticular/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (AAAS protein, human); 0 (Glucocorticoids); 0 (Nerve Tissue Proteins); 0 (Nuclear Pore Complex Proteins); 4964P6T9RB (Aldosterone); 57B09Q7FJR (Dehydroepiandrosterone Sulfate); 9002-60-2 (Adrenocorticotropic Hormone); EC 3.4.23.15 (Renin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0642


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[PMID]:28470148
[Au] Autor:Kleinecke S; Richert S; de Hoz L; Brügger B; Kungl T; Asadollahi E; Quintes S; Blanz J; McGonigal R; Naseri K; Sereda MW; Sachsenheimer T; Lüchtenborg C; Möbius W; Willison H; Baes M; Nave KA; Kassmann CM
[Ad] Endereço:Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
[Ti] Título:Peroxisomal dysfunctions cause lysosomal storage and axonal Kv1 channel redistribution in peripheral neuropathy.
[So] Source:Elife;6, 2017 05 04.
[Is] ISSN:2050-084X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Impairment of peripheral nerve function is frequent in neurometabolic diseases, but mechanistically not well understood. Here, we report a novel disease mechanism and the finding that glial lipid metabolism is critical for axon function, independent of myelin itself. Surprisingly, nerves of Schwann cell-specific mutant mice were unaltered regarding axon numbers, axonal calibers, and myelin sheath thickness by electron microscopy. In search for a molecular mechanism, we revealed enhanced abundance and internodal expression of axonal membrane proteins normally restricted to juxtaparanodal lipid-rafts. Gangliosides were altered and enriched within an expanded lysosomal compartment of paranodal loops. We revealed the same pathological features in a mouse model of human Adrenomyeloneuropathy, preceding disease-onset by one year. Thus, peroxisomal dysfunction causes secondary failure of local lysosomes, thereby impairing the turnover of gangliosides in myelin. This reveals a new aspect of axon-glia interactions, with Schwann cell lipid metabolism regulating the anchorage of juxtaparanodal K 1-channels.
[Mh] Termos MeSH primário: Axônios/enzimologia
Metabolismo dos Lipídeos
Lisossomos/metabolismo
Neuroglia/metabolismo
Doenças do Sistema Nervoso Periférico/fisiopatologia
Peroxissomos/metabolismo
Canais de Potássio de Abertura Dependente da Tensão da Membrana/análise
[Mh] Termos MeSH secundário: Adrenoleucodistrofia/patologia
Animais
Axônios/ultraestrutura
Modelos Animais de Doenças
Seres Humanos
Camundongos
Microscopia Eletrônica
Receptor 1 de Sinal de Orientação para Peroxissomos/deficiência
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Peroxisome-Targeting Signal 1 Receptor); 0 (Pex5 protein, mouse); 0 (Potassium Channels, Voltage-Gated)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180211
[Lr] Data última revisão:
180211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:29187683
[Au] Autor:Hoshino M; Suzuki Y; Akiyama H; Yamada K; Shima S; Mutoh T; Hasegawa Y
[Ad] Endereço:Department of Internal Medicine, Division of Neurology, St Marianna University School of Medicine.
[Ti] Título:[Efficacy of high-dose steroid pulse therapy for anti-galactocerebroside antibody-positive combined central and peripheral demyelination].
[So] Source:Rinsho Shinkeigaku;57(12):747-752, 2017 Dec 27.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 59-year-old man had been admitted to another hospital because of diplopia and thirst at the beginning of March and was diagnosed with diabetic ketoacidosis. He was referred to our hospital because he had limb weakness, dysarthria, and bilateral sensory impairment of the upper limbs, which worsened rapidly from the middle of March, although plasma glucose had been well controlled after the initiation of insulin therapy in the previous hospital. Contrast spinal MRI in our hospital revealed hyperintense lesions at the level of C4 to C5 and T10. The level of myelin basic protein was high (1,260 pg/ml) in the cerebrospinal fluid and serum anti-neurofascin antibody was negative. Nerve conduction study showed typical findings of demyelination at least 2 regions. Although anti-neurofascin antibody was negative, he was diagnosed with combined central and peripheral demyelination (CCPD) based on these clinical findings. After the repeated methylprednisolone pulse therapy for five times, the hyperintense lesions of the spinal cord disappeared gradually. He was bedridden at the beginning of his hospitalization but could ambulate with a cane on discharge 2 months after the admission. Then we received the result of anti-galactocerebroside antibody test as positive. This case suggested that high-dose steroid pulse therapy is safe and may be effective for anti-galactocerebroside antibody-positive CCPD.
[Mh] Termos MeSH primário: Autoanticorpos/sangue
Doenças do Sistema Nervoso Central/diagnóstico
Doenças Desmielinizantes/diagnóstico
Galactosilceramidas/imunologia
Imunoglobulina G/sangue
Metilprednisolona/administração & dosagem
Doenças do Sistema Nervoso Periférico/diagnóstico por imagem
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Moléculas de Adesão Celular/imunologia
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Proteína Básica da Mielina/sangue
Fatores de Crescimento Neural/imunologia
Pulsoterapia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Biomarkers); 0 (Cell Adhesion Molecules); 0 (Galactosylceramides); 0 (Immunoglobulin G); 0 (Myelin Basic Protein); 0 (NFASC protein, human); 0 (Nerve Growth Factors); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-000977


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[PMID]:29182131
[Au] Autor:Begovic N; Paunovic Z; Djuraskovic Z; Lazovic L; Mijovic T; Babic S
[Ti] Título:Lateral pinning versus others procedures in the treatment of supracondylar humerus fractures in children.
[So] Source:Acta Orthop Belg;82(4):866-871, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:We compared results of lateral pinning procedure with crossed pinning, closed reduction, and open reduction in a retrospective review of 184 patients with displaced supracondylar humeral fractures. All patients had a minimum of 2 years follow-up (range 36-90 months). Patients were separated into 4 groups. Success was estimated by Flynn's criteria. We compared success of the lateral pinning to others procedures. Incidence of nerve palsy was recorded and compared. Esthetic effect of lateral pinning is significantly better than closed reduction (p=0.0007), but no significant difference was found comparing with cross pinning and open reduction. Elbow function was similar. Cross pinning procedure was followed with ulnar nerve palsy in ten patients (20.8%). There was 1 case (5%) of combined nerve palsy including ulnar, median and radial nerve after open reduction procedure. Lateral pinning is safe and effective method of therapy for Gartland type II and III supracondylar humeral fractures.
[Mh] Termos MeSH primário: Pinos Ortopédicos
Articulação do Cotovelo/lesões
Fixação Interna de Fraturas/métodos
Fraturas do Úmero/cirurgia
Doenças do Sistema Nervoso Periférico/epidemiologia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Redução Fechada/métodos
Articulação do Cotovelo/cirurgia
Feminino
Seres Humanos
Incidência
Masculino
Neuropatia Mediana/epidemiologia
Redução Aberta/métodos
Neuropatia Radial/epidemiologia
Estudos Retrospectivos
Neuropatias Ulnares/epidemiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  8 / 20557 MEDLINE  
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[PMID]:29260193
[Au] Autor:Srinivasan S; Dehghani C; Pritchard N; Edwards K; Russell AW; Malik RA; Efron N
[Ad] Endereço:Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
[Ti] Título:Corneal and Retinal Neuronal Degeneration in Early Stages of Diabetic Retinopathy.
[So] Source:Invest Ophthalmol Vis Sci;58(14):6365-6373, 2017 Dec 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To examine the neuronal structural integrity of cornea and retina as markers for neuronal degeneration in nonproliferative diabetic retinopathy (NPDR). Methods: Participants were recruited from the broader Brisbane community, Queensland, Australia. Two hundred forty-one participants (187 with diabetes and 54 nondiabetic controls) were examined. Diabetic retinopathy (DR) was graded according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Corneal nerve fiber length (CNFL), corneal nerve branch density (CNBD), corneal nerve fiber tortuosity (CNFT), full retinal thickness, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), focal (FLV) and global loss volumes (GLV), hemoglobin A1c (HbA1c), nephropathy, neuropathy, and cardiovascular measures were examined. Results: The central zone (P = 0.174), parafoveal thickness (P = 0.090), perifovea (P = 0.592), RNFL (P = 0.866), GCC (P = 0.798), and GCC GLV (P = 0.338) did not differ significantly between the groups. In comparison to the control group, those with very mild NPDR and those with mild NPDR had significantly higher focal loss in GCC volume (P = 0.036). CNFL was significantly lower in those with mild NPDR (P = 0.004) in comparison to the control group and those with no DR. The CNBD (P = 0.094) and CNFT (P = 0.458) did not differ between the groups. Conclusions: Both corneal and retinal neuronal degeneration may occur in early stages of diabetic retinopathy. Further studies are required to examine these potential markers for neuronal degeneration in the absence of clinical signs of DR.
[Mh] Termos MeSH primário: Córnea/inervação
Retinopatia Diabética/patologia
Doenças do Sistema Nervoso Periférico/patologia
Retina/patologia
Degeneração Retiniana/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Análise de Variância
Estudos de Casos e Controles
Feminino
Seres Humanos
Masculino
Meia-Idade
Fibras Nervosas/patologia
Queensland
Células Ganglionares da Retina
Tomografia de Coerência Óptica
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-22736


  9 / 20557 MEDLINE  
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[PMID]:29245299
[Au] Autor:Zhang N; Cao J; Zhao M; Sun L
[Ad] Endereço:aDepartment of Neurology and Neuroscience Center, the First Hospital of Jilin University, Changchun, JilinbDepartment of Neurology, Yidu Central Hospital, Weifang, Shandong, China.
[Ti] Título:The introspection on the diagnosis and treatment process of a case of Guillain-Barré syndrome (GBS) attributed to systemic lupus erythematosus (SLE): A case report.
[So] Source:Medicine (Baltimore);96(49):e9037, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Systemic lupus erythematosus (SLE) is an autoimmune inflammatory connective tissue disorder. It may cause neurologic damage which is mainly characterized by central and mental system, while peripheral sexual damage is relatively rare in which Guillain-Barré Syndrome (GBS) as the first performance is more rare . GBS is an autoimmune peripheral neuropathy usually triggered by an antecedent bacterial or viral infection, with SLE being a rare cause. PATIENT CONCERNS: A 65-year-old male presented to the hospital with progressive numbness and adynamia in extremities. His vital signs were stable. 5 days later, his condition aggravated and mechanical ventilation was necessitated owing to severe dyspnea. DIAGNOSES: Based on the clinical symptoms and results of the lumbar puncture and electromyography, he was first diagnosed as GBS, however, after treatment his condition was deteriorate and the blood test showed abnormal immune indices, then renal biopsy was performed, which confirmed the diagnosis of peripheral nervous system in patients with systemic lupus erythematosus (PNS-SLE). INTERVENTIONS: Firstly he was treated with intravenous immunoglobulin (IVIG) for 5 days. After his condition deterioration, he was conducted endotracheal intubation and, finally, a tracheostomy was performed. Later on he was treated with steroid therapy for several weeks. OUTCOMES: The patient showed remarkable recovery and was able to walk on his own by the time of discharge. LESSONS: PNS-SLE can, by itself, be one of the main causes of morbidity and mortality. Electromyography and renal biopsy should be considered when relevant. Peripheral neuropathy in SLE should be given greater recognition, and rarer forms of presentation should be taken seriously in the differential diagnosis when the clinical picture is atypical. Glucocorticoids may play an important role in the treatment of PNS-SLE.
[Mh] Termos MeSH primário: Síndrome de Guillain-Barré/diagnóstico
Imunoglobulinas Intravenosas/uso terapêutico
Lúpus Eritematoso Sistêmico/complicações
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Eletromiografia
Glucocorticoides/uso terapêutico
Síndrome de Guillain-Barré/tratamento farmacológico
Síndrome de Guillain-Barré/etiologia
Seres Humanos
Masculino
Doenças do Sistema Nervoso Periférico/diagnóstico
Doenças do Sistema Nervoso Periférico/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 0 (Immunoglobulins, Intravenous)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009037


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[PMID]:29176796
[Au] Autor:Santos DFD; Mendonça MR; Antunes DE; Sabino EFP; Pereira RC; Goulart LR; Goulart IMB
[Ad] Endereço:National Reference Center for Sanitary Dermatology and Leprosy, Clinics' Hospital, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil.
[Ti] Título:Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects.
[So] Source:PLoS Negl Trop Dis;11(11):e0006086, 2017 Nov.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Leprosy neuropathy is considered the most common peripheral neuropathy of infectious etiology worldwide, representing a public health problem. Clinical diagnosis of primary neural leprosy (PNL) is challenging, since no skin lesions are found and the slit skin smear bacilloscopy is negative. However, there are still controversial concepts regarding the primary-neural versus pure-neural leprosy definition, which will be explored by using multiple clinical-laboratory analyses in this study. METHODOLOGY/PRINCIPAL FINDINGS: Seventy patients diagnosed with primary neural leprosy from 2014 to 2016 underwent clinical, laboratorial and neurophysiological evaluation. All patients presented an asymmetric neural impairment, with nerve thickening in 58.6%. Electroneuromyography showed a pattern of mononeuropathy in 51.4%. Positivity for ELISA anti-PGL1 was 52.9%, while the qPCR of slit skin smear was 78.6%. The qPCR of nerve biopsies was positive in 60.8%. Patients with multiple mononeuropathy patterns showed lower levels of anti-PGL-1 (p = 0.0006), and higher frequency of neural thickening (p = 0.0008) and sensory symptoms (p = 0.01) than those with mononeuropathy. CONCLUSIONS/SIGNIFICANCE: PNL is not a synonym of pure neural leprosy, as this condition may include a generalized immune response and also a skin involvement, documented by molecular findings. Immunological, molecular, and neurophysiological tools must be implemented for diagnosing primary neural leprosy to achieve effective treatment and reduction of its resultant disabilities that still represent a public health problem in several developing nations. Finally, we propose a algorithm and recommendations for the diagnosis of primary neural leprosy based on the combination of the three clinical-laboratorial tools.
[Mh] Termos MeSH primário: Hanseníase Tuberculoide/patologia
Doenças do Sistema Nervoso Periférico/patologia
[Mh] Termos MeSH secundário: Adulto
Algoritmos
Brasil
Feminino
Seres Humanos
Hanseníase Tuberculoide/complicações
Hanseníase Tuberculoide/diagnóstico
Masculino
Meia-Idade
Mycobacterium leprae
Nervos Periféricos/patologia
Doenças do Sistema Nervoso Periférico/diagnóstico
Doenças do Sistema Nervoso Periférico/etiologia
Reação em Cadeia da Polimerase em Tempo Real
Pele/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0006086



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